Non-voluntary euthanasia

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Non-voluntary euthanasia is euthanasia conducted when the explicit consent of the individual concerned is unavailable, such as when the person is in a persistent vegetative state, or in the case of young children.[ citation needed ] It contrasts with involuntary euthanasia, when euthanasia is performed against the will of the patient. [1] [2]

Contents

The different possible situations considered non-voluntary euthanasia are when the decision to end the life of the patient is 1) based on what the incapacitated individual would have wanted if they could be asked, 2) based on what the decision maker would want if he or she were in the patient's place, and 3) made by a doctor based on their own criteria and reasoning. [3]

Euthanasia and religions

The Islamic religion asserts that the human person and his or her life are sacred, and that only God, who gives life, has the right to take it away. Therefore, one must act in all circumstances to preserve and conserve life. Whether it concerns one's own person (suicide) or someone else's, the act of causing death is forbidden. [ citation needed ]

A Quranic verse states: "Whoever kills a person, it is as if he had slain mankind entirely. And whoever saves one, it is as if he had saved mankind entirely ".

The position of the Catholic Church has not changed and evolved little since the Old Testament ban. The last Roman pontiffs have all reaffirmed the ban on euthanasia. The Encyclical Evangelium vitae of Saint John Paul II, of March 25, 1995, is a clear and firm text: “euthanasia is therefore a crime that no human law can claim to legitimize. » Illness is always “a path of conversion” which “provokes a search for God, a return to him”. As for pain, it remains “an access to eternal salvation” and “it can now configure us to Him (Christ) and unite us to his redemptive passion. » (excerpts from the Catechism of the Catholic Church, promulgated by the Vatican in 1992, included in the Compendium of 2005, §1501 and 1505).

Even recently, in June 2016, Pope Francis confirmed this position of the Church in an interview with the newspaper “Christian Family” where he declared that we should not “hide behind so-called compassion to justify and approve of death of a patient. ».

Non-voluntary euthanasia can be divided into passive or active variants. [4] Passive euthanasia entails the withholding of common treatments, such as antibiotics, necessary for the continuance of life. [5] Active euthanasia entails the use of lethal substances or forces, such as administering a lethal injection, to kill and is the most controversial means. A number of authors consider these terms to be misleading and unhelpful. [5]

Active non-voluntary euthanasia is illegal in all countries in the world, although it is practised in the Netherlands on infants (see below) under an agreement between physicians and district attorneys. [6] Passive non-voluntary euthanasia (withholding life support) is legal in various countries, such as India, Albania, and many parts of the United States and is practiced in English hospitals. [7] [8]

Non-voluntary euthanasia has been heavily debated. For example, Len Doyal, a professor of medical ethics and former member of the ethics committee of the British Medical Association, argued for legalization, saying in 2006 that "[p]roponents of voluntary euthanasia should support non-voluntary euthanasia under appropriate circumstances and with proper regulation". [9] Arguing against legalization, Peter Saunders, campaign director for Care Not Killing, an alliance of Christian and disability groups, called Doyal's proposals "the very worst form of medical paternalism whereby doctors can end the lives of patients after making a judgment that their lives are of no value and claim that they are simply acting in their patients' best interests". [10]

Slippery slope debate

Non-voluntary euthanasia is cited as one of the possible outcomes of the slippery slope argument against euthanasia, in which it is claimed that permitting voluntary euthanasia to occur will lead to the support and legalization of non-voluntary and involuntary euthanasia, [11] although other ethicists have contested this idea. [12] [13] [14]

Non-voluntary euthanasia in the Netherlands

Severe hydrocephalus. Infants like this can be subject to non-voluntary euthanasia in the Netherlands if the parents and doctors decide it is the best choice for their child. In other jurisdictions, the doctors involved may be prosecuted. Hydrocephalus-baby.jpg
Severe hydrocephalus. Infants like this can be subject to non-voluntary euthanasia in the Netherlands if the parents and doctors decide it is the best choice for their child. In other jurisdictions, the doctors involved may be prosecuted.

Permitted euthanasia in the Netherlands has been regulated by law since 2002. It states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. [15] Prior to the establishment of that law, euthanasia and assisted suicide in the Netherlands were already tolerated for many years, as for example described by G. van der Wal and R. J. Dillmann in 1994. [16] In a 1994 study, of the studied 5000 requests in the Netherlands, in about 1000 of the cases, doctors prescribed drugs with the explicit goal of shortening the patient's life without the explicit request of the patient, which can be considered cases of non-voluntary euthanasia. [16] [17]

Since 2004, the Netherlands, also has a protocol to be followed in cases of euthanasia on children under the age of 12 (see also below), which was ratified by the Dutch National Association of Pediatricians, although the practice remains technically illegal. Together with colleagues and prosecutors, Eduard Verhagen developed the Groningen Protocol, in which cases prosecutors will refrain from pressing charges. [18] [19]

Non-voluntary euthanasia on children

Newborns and euthanasia

Active euthanasia on newborns is illegal throughout the world, with the de facto exception of the Netherlands mentioned above. Because a newborn child is never able to speak for themselves, euthanasia on newborns is by definition non-voluntary. An early example of documented cases of child euthanasia are those performed by the surgeon Harry J. Haiselden in Chicago in the early 20th century.

Ancient Greece

In ancient Greece, non-voluntary euthanasia of children was practiced as an early form of eugenics, the belief and practice of improving the genetic quality of the human population, usually by withdrawing care (i.e. passive euthanasia) rather than a physical extermination, an act termed as “exposure”. [20]

See also

Related Research Articles

Euthanasia is the practice of intentionally ending life to eliminate pain and suffering.

<span class="mw-page-title-main">Assisted suicide</span> Suicide undertaken with aid from another person

Assisted suicide means a procedure in which people take medications to end their own lives with the help of others, usually medical professionals. The term usually refers to physician-assisted suicide (PAS), which is an end of life measure for a person suffering a painful, terminal illness. Once it is determined that the person's situation qualifies under the physician-assisted suicide laws for that location, the physician's assistance is usually limited to writing a prescription for a lethal dose of drugs.

Medical ethics is an applied branch of ethics which analyzes the practice of clinical medicine and related scientific research. Medical ethics is based on a set of values that professionals can refer to in the case of any confusion or conflict. These values include the respect for autonomy, non-maleficence, beneficence, and justice. Such tenets may allow doctors, care providers, and families to create a treatment plan and work towards the same common goal. These four values are not ranked in order of importance or relevance and they all encompass values pertaining to medical ethics. However, a conflict may arise leading to the need for hierarchy in an ethical system, such that some moral elements overrule others with the purpose of applying the best moral judgement to a difficult medical situation. Medical ethics is particularly relevant in decisions regarding involuntary treatment and involuntary commitment.

Utilitarian bioethics refers to the branch of bioethics that incorporates principles of utilitarianism to directing practices and resources where they will have the most usefulness and highest likelihood to produce happiness, in regards to medicine, health, and medical or biological research.

The right to die is a concept based on the opinion that human beings are entitled to end their life or undergo voluntary euthanasia. Possession of the right to die is often bestowed with the understanding that a person with a terminal illness, incurable pain, or without the will to continue living should be allowed to end their own life, use assisted suicide, or decline life-prolonging treatment. The question of who, if anyone, may be empowered to make this decision is often the subject of debate.

Eduard Verhagen is an attorney and the medical director of the department of pediatrics at the University Medical Center Groningen (UMCG). He is mainly known for his involvement in infant euthanasia in the Netherlands.

Voluntary euthanasia is the ending of a person's life at their request in order to relieve them of suffering. Voluntary euthanasia and physician-assisted suicide (PAS) have been the focus of intense debate in recent years. Some forms of voluntary euthanasia are legal in Australia, Belgium, Canada, Colombia, Luxembourg, the Netherlands, New Zealand, and Spain.

The Groningen Protocol is a medical protocol created in September 2004 by Eduard Verhagen, the medical director of the department of pediatrics at the University Medical Center Groningen (UMCG) in Groningen, the Netherlands. It contains directives with criteria under which physicians can perform "active ending of life on infants" without fear of legal prosecution.

Euthanasia in the Netherlands is regulated by the "Termination of Life on Request and Assisted Suicide Act" which was passed in 2001 and took effect in 2002. It states that euthanasia and physician-assisted suicide are not punishable if the attending physician acts in accordance with criteria of due care. These criteria concern the patient's request, the patient's suffering, the information provided to the patient, the absence of reasonable alternatives, consultation of another physician and the applied method of ending life. To demonstrate their compliance, the Act requires physicians to report euthanasia to a review committee.

Involuntary Euthanasia is currently illegal in all 50 states of the United States. Assisted suicide is legal in 10 jurisdictions in the US: Washington, D.C. and the states of California, Colorado, Oregon, Vermont, New Mexico, Maine, New Jersey, Hawaii, and Washington. The status of assisted suicide is disputed in Montana, though currently authorized per the Montana Supreme Court's ruling in Baxter v. Montana that "nothing in Montana Supreme Court precedent or Montana statutes [indicates] that physician aid in dying is against public policy."

<span class="mw-page-title-main">Legality of euthanasia</span>

The legality of euthanasia varies between countries and territories. Efforts to change government policies on euthanasia of humans in the 20th and 21st centuries have met with limited success in Western countries. Human euthanasia policies have also been developed by a variety of NGOs, most advocacy organisations although medical associations express a range of perspectives, and supporters of palliative care broadly oppose euthanasia.

Len Doyal FRSA FRSocMed is emeritus professor of medical ethics at Queen Mary, University of London and a medical ethicist. He was born in Atlanta, Georgia in 1944 and studied philosophy and sociology at Georgia State University, earning his undergraduate degree in 1966. That same year he was awarded a Fulbright Scholarship to study with Karl Popper at the London School of Economics.

Child euthanasia is a form of euthanasia that is applied to children who are gravely ill or have significant birth defects. In 2005, the Netherlands became the first country since the end of Nazi Germany to decriminalize euthanasia for infants with hopeless prognosis and intractable pain. Nine years later, Belgium amended its 2002 Euthanasia Act to extend the rights of euthanasia to minors. Like euthanasia, there is world-wide public controversy and ethical debate over the moral, philosophical and religious issues of child euthanasia.

Both Euthanasia and Assisted Suicide are illegal in the United Kingdom and could be prosecuted as murder or manslaughter.

Buddhist views, although varying on a series of canons within the three branches of Buddhism, observe the concept of euthanasia, or "mercy killing", in a denunciatory manner. Such methods of euthanasia include voluntary, involuntary, and non-voluntary.

There are many religious views on euthanasia, although many moral theologians are critical of the procedure.

Involuntary euthanasia, typically regarded as a type of murder, occurs when euthanasia is performed on a person who would be able to provide informed consent, but does not, either because they do not want to die, or because they were not asked.

Critics of euthanasia sometimes claim that legalizing any form of the practice will lead to a slippery slope effect, resulting eventually in non-voluntary or even involuntary euthanasia. The slippery slope argument has been present in the euthanasia debate since at least the 1930s.

Organ donation after medical assistance in dying is the donation of organs after death that is medically assisted (MAiD). Both are expressions of human autonomy. The governments of the countries where MAiD is permitted have introduced detailed regulations for this procedure. Combining these procedures requires a combination of the separate regulations applying to each procedure. Popular demand has furthered the development of the combined procedure, known in English-speaking countries as "organ and tissue donation and transplantation after medical assistance in dying " and in Europe as "organ donation after euthanasia (ODE)". By 2020 MAiD by intravenous injection had been legalized in 8 countries and occurred more than 17,000 times including more than 220 ODE procedures.

<i>Informed Consent in Medical Research</i> Medical textbook on Medical ethics

Informed Consent in Medical Research is a medical textbook on medical ethics, authored by Jeffrey S. Tobias and Len Doyal, and published by Wiley in 2001. It was produced in response to the debates between the authors in 1997, following the response to the 1990's British Medical Journal publications of studies in which consent was not obtained by participants. Topics in the book include the Nuremberg Code, Declaration of Helsinki, and the role of Henry K. Beecher and Maurice Pappworth in developing modern ethics in research.

References

  1. ↑ Perrett RW (October 1996). "Buddhism, euthanasia and the sanctity of life". J Med Ethics. 22 (5): 309–13. doi:10.1136/jme.22.5.309. PMC   1377066 . PMID   8910785.
  2. ↑ LaFollette, Hugh (2002). Ethics in practice: an anthology. Oxford: Blackwell. pp. 25–26. ISBN   0-631-22834-9.
  3. ↑ Biggs, Hazel (2001). Euthanasia: Death with Dignity and the Law. Hart Publishing. ISBN   1-84113-091-5.
  4. ↑ Rachels J (January 1975). "Active and passive euthanasia". N. Engl. J. Med. 292 (2): 78–80. doi:10.1056/NEJM197501092920206. PMID   1109443.
  5. 1 2 Harris, NM. (Oct 2001). "The euthanasia debate". J R Army Med Corps. 147 (3): 367–70. doi: 10.1136/jramc-147-03-22 . PMID   11766225.
  6. ↑ "Ending the Life of a Newborn: The Groningen Protocol,: Introduction". www.medscape.com. Archived from the original on 2010-11-09. Retrieved 2009-11-03.
  7. ↑ "India joins select nations in legalising "passive euthanasia"". The Hindu. Chennai, India. 7 March 2011. Archived from the original on 11 March 2011.
  8. ↑ "American Journal of Respiratory and Critical Care Medicine". Archived from the original on 2012-07-01. Retrieved 2011-03-09.
  9. ↑ "'Legalise euthanasia' says expert". BBC News Online . 8 June 2006. Archived from the original on 3 April 2012.
  10. ↑ Boseley, Sarah (8 June 2006). "Call for no-consent euthanasia". The Guardian . London. Archived from the original on 25 February 2017.
  11. ↑ "Voluntary Euthanasia". Stanford Encyclopedia of Philosophy. Stanford University. March 29, 2010. Retrieved June 13, 2010.
  12. ↑ Lewis, P. (2007). "The empirical slippery slope from voluntary to non-voluntary euthanasia". J Law Med Ethics. 35 (1): 197–210. doi:10.1111/j.1748-720X.2007.00124.x. PMID   17341228.
  13. ↑ Ryan, CJ. (Oct 1998). "Pulling up the runaway: the effect of new evidence on euthanasia's slippery slope". J Med Ethics. 24 (5): 341–4. doi:10.1136/jme.24.5.341. PMC   1377611 . PMID   9800591.
  14. ↑ Manninen, BA. (Nov 2006). "A case for justified non-voluntary active euthanasia: exploring the ethics of the Groningen Protocol". J Med Ethics. 32 (11): 643–51. doi:10.1136/jme.2005.014845. PMC   2563300 . PMID   17074822.
  15. ↑ Buiting H, van Delden J, Onwuteaka-Philpsen B, et al. (2009). "Reporting of euthanasia and physician-assisted suicide in the Netherlands: descriptive study". BMC Med Ethics. 10: 18. doi: 10.1186/1472-6939-10-18 . PMC   2781018 . PMID   19860873.
  16. 1 2 van der Wal, G. & R. J. Dillmann (1994). "Euthanasia in the Netherlands". British Medical Journal. 308 (6940): 1346–1349. doi:10.1136/bmj.308.6940.1346. PMC   2540255 . PMID   8019226.
  17. ↑ Fleming, John (June 1992). "Euthanasia, The Netherlands, and Slippery Slopes". Bioethics Notes Research Occasional Paper (1).
  18. ↑ Verhagen, Eduard; Sauer, Pieter J.J. (2005). "The Groningen Protocol — Euthanasia in Severely Ill Newborns". The New England Journal of Medicine . Vol. 352, no. 10. pp. 959–962. doi:10.1056/NEJMp058026. PMID   15758003.
  19. ↑ "Outrage from Churches over Euthanasia on Newborns". December 1, 2004. Archived from the original on September 28, 2007. Retrieved 2007-05-22.
  20. ↑ Patterson, Cynthia (1985). ""Not Worth the Rearing": Causes of Infant Exposure in Ancient Greece". Transactions of the American Philological Association. 115: 111–123.
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